Impact of dietary counselling on allergic reactions in children with food allergy

Purpose: Dietary counselling in the field of food allergy aims primarily to empower individuals to prevent allergic reactions, but its impact on allergic reactions remains unclear. This study examined the impact of dietary counselling and other factors on allergic reactions in children with food allergies. Methods: In a multicentre study, parents of children (0–10 years) recently diagnosed with food allergies completed online questionnaires collecting data on subsequent allergic reactions. Data were collected at baseline and at 3, 6 and 12 months postdiagnosis. We fitted a negative binominal model to the data in order to quantify effects of counselling, time period and multiple food allergies on food allergy reaction rates. Results: Among the 48 enrolled children, 31 encountered a total of 85 food allergic reactions. The monthly reaction rate decreased from 0.28 in the first 3 months to 0.07 between 6 and 12 months. Children receiving counselling from a dietitian demonstrated a lower ratio (incidence rate ratio [IRR] = 0.37, confidence interval [CI] 0.19–0.72, p = 0.004). Those with more than three food allergies have an increased ratio compared to those with one to two food allergies (IRR = 6.18, CI 2.75–3.89, p < 0.001). Conclusion: Individual dietary counselling has the potential to prevent subsequent allergic reactions after diagnosis as it reduced the risk of allergic reactions by 63%. This impact might be most pronounced in the early months following diagnosis. Children with multiple food allergies are at a higher risk of allergic reactions and should, therefore, be prioritized to receive dietary counselling.